Diseases & Conditions

 

Gastroesophageal Reflux Disease (GERD)

Diseases & Conditions

What is Gastroesophageal Reflux Disease (GERD)?

Gastroesophageal Reflux Disease (GERD) is an on-going condition in which the contents of the stomach come back into the esophagus (the muscular tube that carries food and liquids from the mouth to the stomach). This can occur many times a week and could lead to more serious health problems.1Gastroesophageal reflux is also called acid reflux or acid regurgitation because the stomach’s digestive juices contain acid. This will cause heartburn, which is an uncomfortable burning feeling in the chest or in the upper part of the abdomen.

 

What causes GERD?

When we eat, food passes from the mouth to the esophagus and arrives in the stomach. A ring of muscle fibers in the lower esophagus prevents swallowed food from going backward. These muscle fibers are called the lower esophageal sphincter. GERD occurs when the lower esophageal sphincter becomes weak or relaxes, thus causing stomach contents to rise up into the esophagus.2

The lower esophageal sphincter becomes weak due to different reasons: 2

  • Being overweight, obese or pregnant increasing the pressure on the abdomen
  • Certain medicines like asthma drugs, high blood pressure, antihistamines, painkillers and sedatives could cause the weakening of the lower esophageal sphincter
  • Smoking or inhaling secondhand smoke
  • Dietary and lifestyle choices may contribute to GERD. Certain foods and beverages, including chocolate, peppermint, fried or fatty foods, coffee, or alcoholic beverages, may trigger reflux and heartburn.

 

What are the symptoms of GERD?

Common GERD symptoms include:3

  • Chronic cough
  • Asthma
  • Recurrent sore throat
  • Recurrent laryngitis
  • Chest pain
  • Bad breath
  • Nausea
  • Problems swallowing or painful swallowing
  • Respiratory problems

 

How is GERD diagnosed?

A completely accurate test for diagnosing GERD does not exist. However, several tests can help the gastroenterologist with diagnosis: 4

  • Upper gastrointestinal series: This test can look at the shape of the gastrointestinal tract revealing ulcers or sores possibly causing GERD.
  • Upper endoscopy: This test is commonly used to evaluate the severity of GERD by using an endoscope, which is a flexible and small tube with a light to see the upper gastrointestinal tract.
  • Esophageal pH monitoring: This is the most accurate test to detect GERD by measuring the amount of liquid or acid in the esophagus while the person carries on with his normal daily activities. This test consists of passing a thin tube through the mouth to the stomach that will remain for 24 hours.
  • Esophageal manometry: It measures muscle contractions in the esophagus with a tube inserted in the nose into the stomach. This test can show if symptoms are due to a weak sphincter muscle.

 

How is GERD treated?

Treatment of GERD depends on the severity of the symptoms. It includes lifestyle changes, medications or surgery. 5

  • Lifestyle changes

Making lifestyle changes can reduce GERD symptoms. The patient should do the following:

  • Lose weight
  • Wear loose-fitting clothing around stomach area because tight cloth can constrict the area and increase reflux
  • Remain upright for three hours after meal
  • Use extra pillows while sleeping
  • Avoid smoking

 

  • Medications

Take medication under physician’s supervision

People can use many GERD medications over-the-counter. These medications include:

  • Antacids that relieve heartburn and other mild GERD symptoms
  • H2 blockers that provide short-term relief
  • Proton pump inhibitors that relieve symptoms and heal the esophagus lining.

 

  • Surgery:

Surgery is the last option to consider when lifestyle changes and medications did not work. The surgery consists in sewing the top of the stomach around the esophagus to add pressure to the lower end of the esophagus and reduce reflux.

 

Reference:

  1. Lee, Annemarie L., and Roger S. Goldstein. "Gastroesophageal reflux disease in COPD: links and risks." International journal of chronic obstructive pulmonary disease 10 (2015): 1935.
  2. Gastroesophageal reflux disease: MedlinePlus Medical Encyclopedia (U.S National Library of Medicine). https://www.nlm.nih.gov/medlineplus/ency/article/000265.htm
  3. Heidelbaugh, Joel J., et al. "Management of gastroesophageal reflux disease." American family physician 68.7 (2003): 1311-1324.
  4. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/ger-and-gerd-in-adults/Documents/gerd_508.pdf
  5. Treatment for GER and GERD (Treatment for Gastroesophageal Reflux (GER) and Gastroesophageal Reflux Disease (GERD)) http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/ger-and-gerd-in-adults/Pages/treatment.aspx